John X
Age at interview: 66
Brief Outline: John X has osteoarthritis, gout and intermittent high blood pressure. He was ‘a bit shocked’ when told he had kidney ‘damage’, as his father had died of kidney failure as a young man. John X would like more information on the risks and what he could do to help himself.
Background: John X is a retired self-employed pest control technician. He retired 6 years ago due to arthritic pain. He is divorced, has 3 children and lives with his granddaughter. Ethnicity: British/Seychelles.
More about me...
John X has suffered from joint pain caused by osteoarthritis and gout for many years and at the age of 61 decided to retire from his business as a pest control technician. He also experiences intermittent high blood pressure. He takes prescription painkillers (co-codamol and paracetamol) to control his joint pain, and allopurinol for his gout. He also takes daily aspirin to keep his blood thin.
In 2009, John X went through a difficult personal time and started drinking quite heavily for a while. He sought help from his GP who did some blood tests which showed up an enzyme in his liver, suggesting that the liver was working too hard. During the course of a series of liver function tests, it was also mentioned as an aside that John had ‘kidney damage’. He recalls kidney function having been mentioned in previous consultations, but hearing the word ‘kidney damage’ was a shock, especially since John X’s father had died of kidney failure at the age of 32 when John X was still a baby. John X was concerned that the condition might be hereditary and that his drinking may have damaged his kidneys. He felt very motivated to cut down, though he has since found out that alcohol consumption does not affect the kidneys. He was also advised to stop smoking but his GP agreed that cutting down on alcohol was the main priority. The GP referred him for alcohol counselling and John X managed to get his drinking under control.
About two years ago John X was prescribed simvastatin to help lower his cholesterol. However, he stopped taking the tablets after a few days as he was developing pain in his kidneys. He managed to bring down his cholesterol without the medication by cutting out cheese from his diet and generally eating more healthily.
John X is generally quite wary of taking medication as he is concerned about the possible side effects and would rather do other things to help himself. A few years back he had a scary experience when he vomited up blood after taking a single tablet of ibuprofen as he had run out of his regular painkillers. More recently, he stopped taking his allopurinol for gout as a friend had told him that it could harm the kidneys. However, his joint pain quickly got a lot worse, so he asked his doctor for advice, and he was assured that allopurinol was safe to take for him and restarted it.
John X likes to keep informed about health research but he does not currently use the internet. He prefers getting information from papers, the news and books. He likes to be actively involved in decisions about his treatment and is happy to have found a GP who is willing to take the time to explain things properly. Nevertheless, he has some unanswered concerns regarding his kidney health and he would like his check-ups to be slightly more frequent so that a potential decline in his kidney function could be spotted more promptly.
In 2009, John X went through a difficult personal time and started drinking quite heavily for a while. He sought help from his GP who did some blood tests which showed up an enzyme in his liver, suggesting that the liver was working too hard. During the course of a series of liver function tests, it was also mentioned as an aside that John had ‘kidney damage’. He recalls kidney function having been mentioned in previous consultations, but hearing the word ‘kidney damage’ was a shock, especially since John X’s father had died of kidney failure at the age of 32 when John X was still a baby. John X was concerned that the condition might be hereditary and that his drinking may have damaged his kidneys. He felt very motivated to cut down, though he has since found out that alcohol consumption does not affect the kidneys. He was also advised to stop smoking but his GP agreed that cutting down on alcohol was the main priority. The GP referred him for alcohol counselling and John X managed to get his drinking under control.
About two years ago John X was prescribed simvastatin to help lower his cholesterol. However, he stopped taking the tablets after a few days as he was developing pain in his kidneys. He managed to bring down his cholesterol without the medication by cutting out cheese from his diet and generally eating more healthily.
John X is generally quite wary of taking medication as he is concerned about the possible side effects and would rather do other things to help himself. A few years back he had a scary experience when he vomited up blood after taking a single tablet of ibuprofen as he had run out of his regular painkillers. More recently, he stopped taking his allopurinol for gout as a friend had told him that it could harm the kidneys. However, his joint pain quickly got a lot worse, so he asked his doctor for advice, and he was assured that allopurinol was safe to take for him and restarted it.
John X likes to keep informed about health research but he does not currently use the internet. He prefers getting information from papers, the news and books. He likes to be actively involved in decisions about his treatment and is happy to have found a GP who is willing to take the time to explain things properly. Nevertheless, he has some unanswered concerns regarding his kidney health and he would like his check-ups to be slightly more frequent so that a potential decline in his kidney function could be spotted more promptly.
John X was concerned when he got the diagnosis because his father had died of kidney failure at a young age. He also worried about whether his drinking had contributed to his decrease in kidney function.
John X was concerned when he got the diagnosis because his father had died of kidney failure at a young age. He also worried about whether his drinking had contributed to his decrease in kidney function.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Can you remember your father being ill?
No I was- I was a baby when he died yeah. So I didn’t know my father but…
Had you always known that that’s what he died of?
Yes, yes, yeah because my mother had told me.
So there was an awareness of possibly kidney problems in the family?
Well… I didn’t know if it was going to be, what's the word congenital, I didn’t know if it was going to be… or something like that.
Mm hereditary?
Hereditary you know, I didn’t know. …And I hadn’t had any problems at a young age and, you know, nothing was detected then and I've… you know they’ve done tests before, I don’t know.
I'm sure at the time I asked, "Is this to do with drink as well?" you know because… obviously, you know, I'd been cutting that down anyway.
And the GP said “no it's not to do with drink”. So it’s… I think it was just… and said it's just hard luck you know, it's really one of those things. I suppose some people get things and there's no rhyme or reason for it but… that’s the only awareness I had of it, you know, at the time and…I knew before that, that it was a problem. I just thought it was to do with the function, the same as the liver you know, but I didn’t put it down as something different. So I thought, 'Well you know I've got to cut my drink down obviously,' which I was going to do anyway… and not so [laughs].
And did the GP tell you how badly affected your kidneys actually were?
There was a suggestion they’re about probably ten years older than what I am. Which is why I've said about, couldn’t remember them being born before me. I mean things I'd like to know – can I go on to that?
Things I would like to know is “will I ever have to go on to dialysis?” Will they actually fail me? Is there a chance of that? You know, are my kidneys going to… am I going to get kidney failure or something like that?
You know those sorts of questions I'd like to know. You know, I'd like to know the answers to those, mm...
But you didn’t ask at the time?
I did ask- I did ask them back, you know, “will there be… am I looking at dialysis or anything?“ And the doctor said, “no, no, no… not at the moment”, no, so…. So I thought, 'Well hopefully it stays like that then,' you know, let's hope they don’t get any worse you know and cause any more problems.
So did you feel reassured?
A little …[smiles] but you know, and I suppose I'm more sceptical because, you know, my father who certainly was thirty two years old and was very young.
John X has an annual blood test and his blood pressure is checked twice a year but he would prefer more frequent reassurance that his kidney function is stable.
John X has an annual blood test and his blood pressure is checked twice a year but he would prefer more frequent reassurance that his kidney function is stable.
SHOW TEXT VERSION
PRINT TRANSCRIPT
No not really no, no.
So you're quite pleased to be checked up?
Yes, yeah, yeah yeah.
What do you think about the frequency - every six months?
Yeh I think it's more to do with the blood pressure but then they do check other things, so when I have blood tests, so that might be, that might be once a year I'm not quite sure… it's six monthly because sometimes I get this, you know, for the hypertension clinic.
And then I think this is where I put something wrong on the form because it's … it's mainly to go and check the blood pressure I think and then… I don’t think they do that every time with the blood tests.
So in terms of the tests you're having at the moment it's probably a blood test for your kidney function once a year…
Yeah
And then six monthly blood pressure checks.
Yeah, something like that.
And do you have urine tests as well?
Yes usually yeah, yeah, yeah.
What would you like, what would feel reassuring to you, what sort of frequency?
Well even if it was probably every four months or something you know and… I would say on a regular basis, have them… at least over the course of the year if you have three tests done, you know, you’ve got a good example of what… whether it's going up or down.
You know when it's, when it's once every twelve months, once every six months whatever it is now, I can't remember, you can't get that in-between level can you? Now, if you’ve got three tests in a year then you'd get some sort of level. OK it might be up on that one, down on the next one; maybe down on the next one so two out of three isn’t great.
Two bad ones I mean, you know two lower ones but two good ones you're probably feeling a little bit better about yourself and feel… it can't be quite so bad.
Just gives you a little bit of hope I suppose really. It's not going to just go “bumph” [motions with his hand] and it’s finished.
John X wonders whether he needs to change his habit of drinking coffee instead of water. He also wonders whether there are any food supplements that can aid kidney health.
John X wonders whether he needs to change his habit of drinking coffee instead of water. He also wonders whether there are any food supplements that can aid kidney health.
SHOW TEXT VERSION
PRINT TRANSCRIPT
What about the explanation “your kidneys are ten years older than you”. Did you find that helpful?
Well… it was mentioned at first that they are actually older; you know, “they aren't- they’re functioning as somebody older than you”. …So I thought “hmm... well that’s not good you know." But …I suppose I found it helpful when he said they're only ten years older you know. I thought, 'Well I suppose it could be worse, they could be twenty years older, thirty years older,' you know. …But I'd like to know if they could be maintained at that, you know, I mean it could stay the same, or if I can help myself, like I do with the drink.
You know do something else to help. I don’t know if there's anything I could take. You know there might be some supplement that’s … needed, I don’t know, but nothing's been mentioned on that so, you know, that’s…those are the sorts of things I'd like to know I suppose, yeah.
John X sought help with reducing his alcohol consumption after learning he had a liver problem. He rarely drinks nowadays.
John X sought help with reducing his alcohol consumption after learning he had a liver problem. He rarely drinks nowadays.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Did the GP offer you any help with that? Did you discuss the drinking with your GP?
I did yes. I did go somewhere to see about the drinking, yeah. And that helped a little bit, one of these places you know that you go and…you know, talk to people and just…
Was that in the GP practice or was it like a specialist alcohol services?
There was another alcohol service; I can't remember the name of them now. But I think it was suggested that I go there… which I did, but you know. But then I decided to do it myself anyway so, you know to cut down, not…you know… not sort of drink every day and, you know, cut the amount down with a reasonable amount. And… but I don’t go out to the pub at all now so I might just have a couple of cans in or something, you know so. Very rare I go to the pub, and if I do I just have a soft drink and have something to eat usually and that’s all I do now.
Was it hard making those changes?
Not really. I think it was because of the problem at the time.
Mm… going through the divorce?
Yeah and through that and a few things back through life you know and I decided I… I hit the drink a bit but I just don’t see the need for it now and I… you know.